Use of closed suction drainage after primary total hip arthroplasty: a prospective randomized controlled trial

Fagotti, Lorenzo; Ejnisman, Leandro; Miyahara, Helder de Souza; Gurgel, Henrique Melo de Campos; Croci, Alberto Tesconi; Vicente, José Ricardo Negreiros

doi:10.1016/j.rboe.2018.01.001

Cited by 6 publications

(10 citation statements)

References 22 publications

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“…Fagotti et al reported two SSIs in the drainage group but no deep periprosthetic infections; in the no-drainage group, there were no SSIs, but one patient was diagnosed with a deep infection. However, there were no signi cant differences between groups [15]. Walmsley et al, in a study of 552 patients (577 hip joints), reported a higher incidence of SSIs (48% vs 2.9%) and deep infections (0.7% vs 0.4%) in no-drainage patients [16].…”

Section: Discussionmentioning

confidence: 92%

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Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Bartosz¹,

Marczyński

Para

et al. 2020

Preprint

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Background: Several studies have suggested that the use of drains did not improve surgical outcomes after hip replacement. There is still a lack of strict recommendations for drainage use.Methods: Prospective, randomised study was performed. The analysis included 100 patients. Inclusion criteria: idiopathic hip osteoarthritis. Exclusion criteria: secondary coxarthrosis, autoimmune disease, coagulopathy, venous/arterial thrombosis, hepatic/renal insufficiency, cement, or hybrid endoprostheses. Results: We found smaller haematomas in the no-drainage group (9.76 mm vs. 10.33 mm, p = 0.653). The visual analogue scale score was lower in the no-drainage group (5 vs. 6). Less bloodloss in the no-drainage group (1,124 ml vs 1,224 ml, p = 0.59). Two patients had a deep joint infection in the no-drainage group, none in the drainage group.Conclusion: It is noteworthy that two cases of early infections were observed in the no-drainage group, whereas there were no such complications in the drainage group. Further research is warranted to validate our findings.Trial registration: The study was successfully retrospectively registered in Clinicaltrial.gov with identification number: NCT04333264 (03/04/2020). https://clinicaltrials.gov/ct2/show/NCT04333264?term=NCT04333264&draw=2&rank=1

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Section: Discussionmentioning

confidence: 92%

“…In most relevant publications, the majority of parameters did not differ signi cantly between groups [15][16][17]21]. All these studies included heterogeneous groups; patients with primary and secondary osteoarthritis, coxarthrosis in the course of rheumatoid arthritis, and others.…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Bartosz¹,

Marczyński

Para

et al. 2020

Preprint

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“…5 As already concluded in previous studies on smaller patient populations and summarizing our results, the slight improvement in the short-term post-surgical pain level does not justify the use of a drain when taking the increased risk of blood transfusion into consideration. 7,8…”

Section: Discussionmentioning

confidence: 99%

“…5 Reports on the efficiency of wound drainage following THA are contradicted by others showing additional risks of this practice. 6–8…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the potential complications of surgical wound drainage in primary total hip arthroplasty: a prospective controlled double-blind study

2020

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Background: The routine use of postoperative wound drainage following total hip arthroplasty (THA) to avoid the creation of excessive haematomas is controversial because of the potential risk of blood loss and wound infection. Methods: In a prospective double-blind controlled study, 2 groups of patients with hip joint osteoarthritis were operated with primary THA, 1 with surgical wound negative pressure drainage (Group 1 – 635 patients) and the other without (Group 2 – 527 patients). Postoperative blood haemoglobin and haematocrit levels, the necessity for blood transfusion, values of the potential infection markers (serum C-reactive protein values and erythrocyte sedimentation rate), postoperative pain level (according to the VAS scale) and functional outcome (according to Harris Hip Score [HHS] and SF-36 scores) at 12 months postoperatively were compared. Results: A significantly higher drop in blood haemoglobin and haematocrit values was observed in the Group 1 patients (mean drop of 2.2 gr/dl ± 0.25 vs. 1.6 gr/dl ± 0.35 and mean drop of 16% ± 4.0 vs. 11% ± 3.0, respectively, p < 0.01, paired t test). The need for blood transfusion was significantly higher in the Group 1 patients (4.9% vs. 3.9%, p < 0.05, t test). The severity of pain (VAS scale) on the first day after the operation was significantly lower in the Group 1 patients ( p < 0.05, t test), but overall, in both groups it was of low intensity (VAS <3). A similar postoperative wound infection rate was observed in both groups (0.4%). HHS and SF-36 scores were similar in both groups. Conclusions: The drainage of surgical wounds following primary THA due to hip osteoarthritis has a low added value and might cause an increased requirement for blood transfusion.

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“…Current literature for primary total hip arthroplasties (THA) shows no bene ts of closed suction drainage after surgery [1,2]. Revision hip arthroplasties (RHA) compared to primary procedures are more aggravating for both patients and surgeons.…”

Section: Introductionmentioning

confidence: 99%

Excessive Blood Loss After Revision Hip Arthroplasty is Related to the use of Closed Suction Drainage: A Prospective Randomized Study

Bartosz¹,

Grzelecki²,

Chaberek³

et al. 2021

Preprint

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Background:Suction drainage after primary total hip arthroplasties (THA) offers no benefits. Revision hip arthroplasties (RHA) are more demanding procedures and associated with greater blood loss compared to primary cases. There is still a lack of literature regarding the application of drainage in RHA.Material and Methods:A total of 40 patients who underwent RHA were included in this prospective study. Simple randomization with an allocation ratio 1:1 was performed. Primary outcomes: total blood loss, hemoglobin drop, joint hematoma size in USG, infection. Secondary outcomes: blood transfusion rate, soft tissue hematomas, C-reactive protein levels, Visual Analogue Scale before and on 3rd day after surgery, Harris Hip Score before and 6 weeks after surgery. An intention to treat analysis was performed, with a 2-year follow up.Results:Statistically significant differences between groups was in blood loss: drainage 1559.78 ml, non-drainage 1058.27 ml, (p=0.029) and hemoglobin level on 1st day after surgery: drainage 10.58 g/dl, non-drainage 11.61 g/dl (p=0.0496). In terms of the other analyzed parameters, statistical differences were not found. Conclusion:Our study revealed that the use of suction drainage may lead to higher blood loss in the early postoperative period. Further studies are needed to evaluate our results.

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Use of closed suction drainage after primary total hip arthroplasty: a prospective randomized controlled trial

Cited by 6 publications

References 22 publications

Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Evaluation of the potential complications of surgical wound drainage in primary total hip arthroplasty: a prospective controlled double-blind study

Excessive Blood Loss After Revision Hip Arthroplasty is Related to the use of Closed Suction Drainage: A Prospective Randomized Study

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Use of closed suction drainage after primary total hip arthroplasty: a prospective randomized controlled trial

Cited by 6 publications

References 22 publications

Clinical&nbsp;Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Clinical&nbsp;Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Evaluation of the potential complications of surgical wound drainage in primary total hip arthroplasty: a prospective controlled double-blind study

Excessive Blood Loss After Revision Hip Arthroplasty is Related to the use of Closed Suction Drainage: A Prospective Randomized Study

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Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study

Clinical Analysis of Suction Drainage in Cementless Hip Replacement: A Prospective Randomised Study